Laserfiche WebLink
I <br /> I HOUSTON LABORATORY <br /> 8880 INTERCHANGE DRIVE <br /> HOUSTON TEXAS 77054 <br /> rJ (713)660-0901 <br /> Sample Recei t Checklist <br /> Workorder 01060855 Received By DS <br /> Date and Time Received 6126101 9 30 00 AM Camer name FedEx <br /> ITemperature 4 Chilled by Water Ice <br /> 1 <br /> Shipping container/cooler in good condition? Yes 21 No ❑ Not Present ❑ <br /> I2 Custody seals Intact on shippping containerlcooier'? Yes ❑ No❑ Not Present <br /> 3 Custody seals intact on sample bottles? Yes ❑ No❑ Not Present <br /> I <br /> 4 Chain of custody present? Yes No❑ <br /> 5 Chain of custody signed when relinquished and received? Yes 0 No❑ <br /> i <br /> 6 Chain of custody agrees with sample labels? Yes No❑ <br /> 7 Samples in proper containeribattle? Yes No❑ <br /> 14% Sample containers intact? Yes ❑ No❑ <br /> 9 Sufficient sample volume for Indicated test' Yes ❑ No❑ <br /> 10 All samples received within holding time? Yes No❑ <br /> 11 Containerrremp Blank temperature in compliance? Yes 0 No❑ <br /> 12 Water-VOA vials have zero headspace? Yes No❑ Not Applicable ❑ <br /> 13 Water pH acceptable upon receipt? Yes No❑ Not Applicable ❑ <br /> SPL Representative Contact Date&Time <br /> Client Name Contacted ��� <br /> Non Conformance <br /> Issues <br /> Client Instructions <br /> I <br /> 01060855 Page 34 <br /> 7117/01 2 34 28 PM <br /> 1 <br />