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2009041167 04/16/2009 ' <br /> Sample Integrity Pg. 1 of 2 I Geo Con TAT: Standard <br /> 416033 t <br /> Date Received <br /> Section 1-Sampled Same Day ' <br /> Sample p Ik In SJVC B C r Transported In: Ice Chest Box Hand <br /> as chillin ess begun? Y N Samples Receiv d. Chilled to Touch / Ambient / On Ice ' <br /> Section 2-Sampled Previously <br /> Sample Transport: CAO UPS SJVC Walk-In BSK-Courie� GSO Fed Exp. Other: ' <br /> No. Coolers/Ice Chests: Temperature(s): lG <br /> Was Temperature In Range.. Y N Received On Ice: Wet ' Blue ' <br /> Describe type of packing materials: ubble W ap Foam Packing Peanuts Paper Other: <br /> Were ice chest custody seals resent? Intact: Y N ' <br /> Section 3-COC Info. Completed Info From Completed Info From <br /> Yes No Container Yes No Container , <br /> Was COC Received Analysis Requested <br /> Date Sampled Any bold times less than 72hr <br /> Time Sampled Client Name ' <br /> Sample ID Address <br /> Special Storage/Handling Storage/HandlingIns. Telephone# <br /> Section 4-Bottles/Analysis Yes No N/A Comment ' <br /> Did all bottles arrive unbroken and intact?: <br /> Were bottle custody seals resent? ' <br /> Were bottle custody seals intact? <br /> Did all bottle labels agree with COC?: <br /> Were correct containers used for the tests requested?: t <br /> Were correct reservations used for the tests requested?: <br /> Was a sufficient amount of sample sent for tests indicated?: <br /> Were bubbles resent in VOA Vials?: Volatile Methods Only) ' <br /> Were Ascorbic Acid Bottles received with the VOAs <br /> Section 5- Comments/Discrepa re ' <br /> Sample(s) Split/Preserve: Yes o Container: Preservation: Init.: <br /> Was Client Service Rep. notified of discrepancies: Yes No N/A CSR: Notified By: <br /> Explanations/Comments <br /> Report Comment Entered: �j ' <br /> SR-FL-0002-02 Labeled by:111L — Labels check —mac <br />