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® TL <br /> TL San Francisco <br /> arnpie F e eipt C heckIist <br /> Submission #.2003- - <br /> Checklist completed by. initiats) Date: IL!AID3 <br /> Courier narne: D STL San Francisco �rit <br /> Not <br /> Custody seats intact an shippiryg conteiner/aamples Yes Na Present <br /> Chaln of custody present? Yes hlo <br /> Chaim of custody signed when relinquished and received? Yes`�No <br /> Chain of custody agrees with sample labels? YesJo <br /> Samples in proper containeVbotUe? Yes i o <br /> Sample containers intact? YesNo <br /> Sufficient sampte volume for indicated lest? <br /> All samples received within Bolding time? Yeses o _ <br /> Containerfremp Blank temperature In compliance (49 C_Z)? Temp:,,,- ° Yeses !o <br /> Ice Present Yes­pNo <br /> Water- VOA vials have zero headspace? No VOA via ls--submftted-,<f'Yes No <br /> 'if bubble is presen[, refer to app roximMe bubble size and iternize in cornments as 5 (small—Q), M (mediii m -- ) or L (large# 0) <br /> Water- pH acceptable upon receipt" ❑ Yes Q Na 3 i <br /> �, <br /> ❑ pH adjusted- Preservative used: ❑ HN08 1711 HCI ❑ H2504 ❑ NaOH ❑ Zn OAc-Lot#(s) <br /> For any item chez k-listed "No", previded detail of discrepancy ire comment saction be law: <br /> Comments: SAA <br /> { Y L+ <br /> Project Management [routing for instruction of indicated discrepancy(ies)] <br /> Project Manager. (initials) Date: :. - 103 <br /> Client canfacted: 0 Yes 0 No <br /> Summary of discus&idri; <br /> t <br /> Ci�fn 'five Acton (per PMI lient): <br />