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I <br /> ® STL <br /> M <br /> STL San Francisco <br /> Sample Receipt Checklist <br /> Oubmission # 2004- - Q Y!VV <br /> Checklist completed by (initials) Date _1 30104 <br /> Courier name A STL San Francisco ❑ Client <br /> Not <br /> Custody seals intact on shipping container/samples Yes No Present <br /> Chain of custody present? Yes r No <br /> Cham of custody signed when relinquished and received' Yes //No <br /> Chain of custody agrees with sample labels? Yes V No <br /> Samples in proper container/bottle? Yes-4,-'No <br /> Sample containers intact? Yes__kZNo <br /> Sufficient sample volume for indicated fest? Yes L/No <br /> All samples received within holding time? Yes L-""No <br /> Cori( inerllerr�a Blarilc� rtaj� }[�R411 ec <br /> j E m rli 4 '"y^'. ' v [i ,.'x.r t"`- '4 i_ •:' `n, E C pm ^E-_u7 �e' mC'A.'.' :.x.v`==_ > <br /> �b art r'" ,� s�s f A '�x� -e ,re•� a,c4 • . - � f`"r�3� 'i; �.z=v2 s"�' "� 35`r w. '�.. �,�"�°� <br /> eater-VOA vials have zero headspace? No VOA vials submitted Yes V�-'No <br /> (if bubble is present, refer to approximate bubble size and itemize in comments as S (small-0) M (medium- 0)or L(large-- O) <br /> Water- pH acceptable upon receipt? ❑Yes ❑ No <br /> ❑ pH adjusted- Preservative used ❑ HNO3 0 HCI 13 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 dlscrepancy(ies)] <br /> Project Manager (initials) Date 1 104 Client contacted ❑ Yes ❑ No <br /> Summary of discussion <br /> corrective Action(per PM/Client) <br />