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Sample Receipt 1 Client Notification Form <br /> Client Name: f• F` <br /> SIERRA Sierra Project Number: 91 <br /> LABORATORIES <br /> Sierra Project Manager: A • <br /> Date/Time Samples Received: V • I 1 6 Z I c> <br /> Method of Shipment: v• P • S <br /> Custody Seals? 0 NIA ['Intact ❑ Broken <br /> Samples Intact? S <br /> Properly Labelled? S <br /> Appropriate Containers? Y-e-S <br /> Headspace in VDA vials? <br /> Samples Chilled? (Cooler Temp. "C): ! • Z <br /> Properly Preserved?(pH) ` <br /> Preservatives added(after receipt by Sierra):_ bv1L-e— <br /> ' Sample Disposal instructions: (I`C�- 4— <br /> "Turn <br /> —*"Turn Around Time Requested: r, rt <br /> Subcontractor Laboratories to be utilized: <br /> Special Instructions: <br /> Other Anomalies: <br /> Date/Time Faxed to Client: <br /> Samples bogged in by: <br /> Printed Name: <br /> If you have any questions, please reter to the Sierra Project Number referenced above. <br /> '-Samples are only retained for 30 days if marked for Lab Dlsposal. Other charges may apply for other disposal options. <br /> Rush surcharges will be applied to Tum Around Times other than Normal,except by prior arrangement with Sierra Lams. <br /> 26052 MERIT CIRCLE, SUITE 105, LAGUNA HILLS, C4LTFORNIA 92553 <br /> TELEPHONE: (714) 348-9389 FAX: (714) 348-9115 <br />