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Sample Receipt 1 Client Notification Form <br /> ' Client Name G, <br /> SIERRA Sierra Project Number 5c7D-7-16 6, <br /> LABORATORIES -- <br />' Sierra Project Manager <br /> Date I Time Samples Received <br />' Method of Shipment JAJ 5 <br />' Custody Seals? � NIA L! Intact Broken <br /> Samples Intact? I/ <br />' Properly Labelled? l/ <br /> Appropriate Containers <br />' Headspace In VOA vials N0,,4i <br /> Samples Chilled? (Cooler Temp °C) 6'4'c- <br /> Properly <br /> Properly Preserved? (pH) /-fC G— <br /> Preservatives added (after receipt by Sierra) <br /> " Sample Disposal Instructions <br /> ' Tum Around Time Requested CTW,4. <br /> Subcontractor Laboratories to be utilized <br /> ' Special Instructions <br /> Other Anomalies <br /> DatelTime Faxed to Client <br /> ' Samples Logged in by <br /> Printed Name �0-- �,,4 . ( , <br /> JF <br /> If you have any questions, please refer to the Sierra Project Number referenced above <br /> Samples are only retained for 30 days if marked for Lab Oisposal 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 Srerra Labs <br /> ' 26052 MEAT CIRCLE, SUITE 105, LAGUNA HILLS CALIFORNIA 92653 <br /> �t_i iroHrl(+lF !7S 11 ?.!A 4'7po C-1 r 57� 1) 348 01.,5 <br />