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LABO <br /> ATORY <br />' HOUSTONTE CHANGE DRIVE <br /> 8880?NTERCHANGE DRIVE <br /> HOUSTON TEXAS 77054 <br /> �} {743}560 0801 <br />' Sample Receipt Checklist <br /> 1Norkorder 00120503 Received by Stelly DAnna <br /> Date and Time Received 12115/00 10 00 00 AM Carrier name FedEx <br />' Temperature 2 <br /> Shipping container/cooler in good condition? Yes d No _ Not Present <br /> Custody seals intact on shippping container/cooler's Yes _ No Not Present <br /> Custody seals intact on sample Mottles? Yes _ No _ Not Present <br /> Chain of custody present? Yes ��' No <br />' Chain of custody signed when relinquished and received? Yes 171 No <br /> Chain of custody agrees with sample labels? Yes No - <br /> Samples in proper container/bottle? Yes +_/ No <br /> Sampfe containers intact? Yesti/ No <br />' Sufficient sample volume for indicated test? Yes �!' No _ <br /> All samples received within holding time? Yes No <br /> fltainer/Temp Blank temperature in compliance? Yes d' No _ <br /> ater-VOA vrafs have zero headspace? Yes No Not Present <br /> Water-pH acceptable upon receipt? Yes No <br /> I <br /> 00120503 Page 34 <br /> 112101 90401 AM <br />