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1 <br /> Sample Receipt / Client Notification Form <br /> ........%kClient Name GHFI ' <br /> SIERRA Sierra Protect Number !i-yo <br /> LABdRATpRMS ' <br /> Sierra Project Manager Bill Hudson <br /> Date/Time Samples Received / 4J. f o , 3� ' <br /> Method of Shipment UPS Next Day Air <br /> Custody Seals? �V NIA E� Intact El Broken <br /> Samples Intact? Yes <br /> Properly Labelled? Yes ' <br /> Appropriate Containers? Yes ' <br /> Headspace in VOA vials? None <br /> Samples Chilled? (Cooler Temp °C) Yes ✓ ' <br /> Properly Preserved? (pH) Yes <br /> Preservatives added (after receipt by Sierra) NIA ' <br /> " Sample Disposal Instructions Lab Disposal ' <br /> Tum Around Time Requested 2 weeks (Normal) <br /> Subcontractor Laboratories to be utilized NIA ' <br /> Special instructions Bili USA Petroleum <br /> Please Provide Chromatograms <br /> & Check In Sheet ' <br /> Other Anomalies None <br /> r <br /> Date/Time Faxed to Client AJ)A- <br /> Samples <br /> -Samples Logged in by <br /> Printed Name �v Z � /�✓J o Z.�,f <br /> If you have any questions, please refer to the Sierra Project Number referenced above • <br /> '-Samples are ortly retained for 3o days it marked for Lab Disposal other charges may aDDiv for other disposal options <br /> -Rush surcharges will be applied to Turn,4rourrd Tmes other than Normal,except by pncr arrangement with Sierra Labs <br /> 26052 Z"ERIT C=PCrr_^c, Su=71� 105, LAGi11i.7. &;=,LS ' - <br /> 92S53(714) =49-4589 (714) 343-9_,5 <br />