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STL <br /> 'STL San Francisco <br /> Sample Receipt Checklist <br /> Wbmission #.2004- 8 5 <br /> Checklist completed by (initials) Date 13 d IQa <br /> Courier name YISTL San Francisco ❑ Client <br /> Custody seals intact on shipping container/samples Not <br /> Yes No Present <br /> Chain of custody present? Yes J No <br /> Chain of custody signed when relinquished and received? Yes /No <br /> Chain of custody agrees with sample labels? Yes `� No <br /> Samples in proper containerlbottle? Yes No <br /> Sample containers intact? Yes / No <br /> Sufficient sample volume for indicated test? Yes / No <br /> All samples received within holding time? Yes No <br /> -b tail 6 BlartkJ 7n e -'� nh Oka io <br /> 9 �a: `y� t z� � )? � ! � 4 � s r ,� s , s� p� C> `Yes> I <br /> s ' !" a e "" Xitar°�� �5,»°' - ' d� f s r_'`�' '° r� m t <br /> ��]Q,��,w❑`r N¢tTe�DiJgh ICi;,❑?dVot efiou �U�I � _ �,€� <br /> eater-VOA vials have zero headspace? No VOA vials submitted Yes-,,/ No <br /> (if bubble is present, refer to approximate bubble size and itemize in comments as S (small --O), M (medium- O) or L(large- O) <br /> Water-pH acceptable upon receipt? ❑Yes ❑ No <br /> ❑ pH adjusted- Preservative used ❑ HNO3❑ HCI ❑ H2SO4 ❑ NaOH ❑ZnOAc-Lot#(s) <br /> For any item check-fisted "No", provided detail of discrepancy in comment section below <br /> Comments <br /> Project Management [Routing for Instruction of Indicated dlscrepancy(ies)] <br /> Protect Manager (initials) Date / 104 Client contacted ❑ Yes ❑ No <br /> Summary of discussion <br /> 0,rrective Action (per PM/Client) <br />