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Sample Receipt Checklist STL San Francisco <br /> Submission #: 2002- 03 - 0 �0 <br /> Checklist completed by (initials) Date <br /> Courier name ❑ STL San Franciscoxclient <br /> Not <br /> Custody seals intact on shipping containerlsamples Yes No Present <br /> Chain of custody present? Yes �No <br /> Chain of custody signed when relinquished and received? Yes No <br /> Cham of custody agrees with sample labels? Yes `� No <br /> Samples in propercontamer/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 L""No <br /> Containerfremp Blank temperature in compliance (40 C=2)? Temp ( OC Yes L-,"/No <br /> Water-VOA vials have zero headspace? No VOA vials submitted Yes L,-"'-No <br /> (if bubble is present, refer to approximate bubble size and itemize in comments as S (small -O) M (mecium - O)or L (large - 0) <br /> Water-pH acceptable upon receipt? XYes ❑ No <br /> © pH adjusted- Preservative used ❑ HNO3 Cl HCI ❑ HzSOa ❑ NaOH ❑ZnOAc <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(les)] <br /> Project Manager (initials) Date / 102 <br /> Client contacted ❑ Yes ❑ No <br /> Summary of discussion <br /> 0 Corrective Action(per PM/Client) <br />