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LA <br />ASSOCIATED LABORATORIES <br />806 North Batavia – Orange, California 92868 – 714-771-6900 <br />SAMPLE ACCEPTANCE CHECKLIST <br />FAX 714-538-1209 <br />Section P <br />Client: )�"()2 bovt Project: <br />Date Received: Sampler's Name: C-YU3, No <br />Sample(s) received iA cool e :(T!)No (Skip Section 2) <br />Sliippino Information: <br />Section 2 <br />Was the cooler packed with. <br />Cooler or box temperature: <br />(Acceptance range is 2 to 6 Deg. C.) <br />Ice X Ice Packs %Bubble Wrap <br />Paper None — Other <br />— Styrofoam <br />Section 3 YES NO N/A <br />Was a COC received? <br />Is it properly completed? (IDs, sampling date and time, si ature, test) <br />Were custody seals resent? X <br />If Yes – were they intact? <br />Were all samples sealed in plastic bags? <br />Did all samples arrive intact? If no, indicate below. <br />Did all bottle labels agree with COC? (ID, dates and times) <br />Were correct containers used for the tests required? <br />Was a sufficient amount of sample sent for tests indicated? <br />Was there heads ace in VOA vials? <br />Were the containers labeled with correct preservatives? <br />Was total residual chlorine measured (Fish Bioassay sample only)? <br />*: If the answer is no, please inrorm rrsn Dwa,�ibay <br />Section 4 <br />Section 5 <br />Was Project Manager notified of d <br />Y/N N/A <br />Completed By: J/1h- Date: �` <br />