Laserfiche WebLink
STL <br /> STL San Francisco , <br /> Sample Receipt Checklist <br /> Submission #:2005- - <br /> Checklist completed by: (initials) CDM M Date: <br /> Courier name: STt_ San Francisco ❑ Client <br /> Not <br /> Custody seals intact on shipping container/samples Yes No Present <br /> Chain of custody present? Yes Into <br /> Chain of custody signed when relinquished and received? Yes No <br /> Chain of custody agrees with sample labels? Yes r No <br /> Samples in proper container/bottle? Yes--4—NO <br /> Sample containers intact? Yes No <br /> Sufficient sample volume for indicated test? Yes <br /> les received within holding All samples g time? Yes No <br /> Contairiefftemp Blank tomRprafur'e m complianc'6:(4o C+2)? pomp ° Yes' t No <br /> Potential reason dor>6 C..=ice'Meljed'C7 Ice jr3 bags D jVof eto�igh rce. ot enough blue ice p Samples m'boxes !7 <br /> Sampled<4hr, ago?❑ Iceir or'�bulk sample}y0 ' / <br /> Ice Present Yesn. <br /> No VOA vials submitted Yes No <br /> Water- VOA vials have zero headspace? <br /> (if bubble is present, refer to approximate bubble size and itemize in comments as 5 (small -O). M (medium — 0) or L{large-- 0) <br /> Water- pH acceptable upon receipt? ❑ Yes ❑ No <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 /> Project Management [Routing for instruction of indicated discrepancy(ies)] <br /> Project Manager: (initials) Date: 1 105 <br /> Client contacted: ❑ Yes ❑ No <br /> Summary of discussion: <br /> Corrective Action (per PM/Client): <br /> i <br />