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STL <br /> STL San Francisco <br /> Sample Receipt Checklist <br /> Submission #;2043- 01�'� <br /> ChecMist'c mpteted by: Unitlals)._ pate: 1 y'3 )03 <br /> i <br /> Cowrirer name, q:STL San Fmnciaco ❑ Ghent <br /> Not <br /> Cutitodysesls intticit on shipping contain erisarnpies Vas^Ne_ Present <br /> Chaim of=study present? " Yes No <br /> Ii Chain of custody signed vrhert rellngOshed and received? Yes f HQ <br /> ChMn of custody agrees w tfir sarnolelabe t? Yes— No <br /> Samples in proper containerlbodle? Yes' ESId_ <br /> j $ample.containers Intact? Yeses No__ <br /> Sufflciant sampla:volurne for Indicated lost? 1'es Nb <br /> Pit samples.received Within hoidIng Umefi Yes. talo <br /> Contain6fffemp BlanN temperaturia in compliance(40 C.+-2)? Te Yes;ZNO <br /> tca Present Yeses �o <br /> Watts`-Vbi�vials have,,zera heaospace? No VCA vi.sis ubmitted Yi9 Na <br /> (if l tihble is present; reEfer Im approximate tubbie zlze and itemize in w mater l&as.$'(smail -0_1,N (mediurn-- or L(large- 0) <br /> Water- pH acGeptpbte upon receipt? es Q Nc ! <br /> Q pfd adjusted- Preservrnive used: ❑ HNCj 0 HCl❑ H230i : iVaaH .ZriOAo. Lot-iii(s) � <br /> For any it m,chackAisted "No", provided detail of }ii�JOrnmi btsie4on,�bifd.k <br /> comments, <br /> I <br /> Prvje. # Nl rag t l n Ra[Jtiln: � r in ttu #eon'Of [ a#e is oon �i )3 <br /> Project Manogor:.Or lEtia(s) 17 t . f ICS 1 <br /> Giant cont2igGed: 0 Yes 0 No <br /> �Url'trn�{y sit•d1[sc,�sai�n, <br /> I <br /> I,. <br /> .urric,`l�-e Adtfarl(psr PA1dtrlisRtl.; <br />