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� STL , <br /> STL San Francisco <br /> Sample Receipt Checklist <br /> Stmission #.2003- 0�� <br /> Checklist completed by (initials) Date 1✓ ! l03 <br /> Courier namesTL San Francisco ❑Client Not <br /> ,I �` Yes No Present , <br /> Custody seals intact on shipping container/samples <br /> ; <br /> Cham Yes�o of custody presents / <br /> Cham of custody signed when relinquished and received? Yes ✓No <br /> Chain of custody agrees with sample labels? Yes No <br /> Yes `� No <br /> Samples in proper container/bottle? <br /> Yes ✓ No <br /> Sample containers intact <br /> Yes ✓ No <br /> Sufficient sample volume for indicated test <br /> Yes ✓ No <br /> All samples received within holding time? <br /> ContainerfTemp Blank temperature in compliance (40 C±2)'? Temp—5,--S--C Yes V Na <br /> ice Present Yes ✓ No <br /> .-I,Water-VOA vials have zero headspace? No VOA vials submitted Yes No <br /> 0 0) or L(lar e-- 0! <br /> (if bubble is present refer to approximate bubble size and itemize in comments as S (small–O), M (medium _ g ) <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-listed "No", provided detail of discrepancy in comment section below <br /> Comments <br /> Project Management [Routing for instruction of indicated dllscrepancy(les)] <br /> Project Manager (initials) Date 1 /03 <br /> Client contacted ❑ Yes ❑ No <br /> Summary of discussion <br /> Orrective ActtDn(per PM/Client) <br />