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SunStabar <br /> ries <br /> Lorato , i Page I of <br /> Pxaviaxn QUA�ab Axam oriel NenOx Inc.nnc <br /> SAMPLE RE C IVING REVIEW SHEET <br /> BATCH# <br /> Client Name: -yL- - vAA Project: TrtCcy orey�tFavir2 <br /> Received by: Rryr a^/ Date/Time Received: ZZO-i 4 A.•S/S <br /> Delivered by: ❑Client ❑SunStar C urie'r ®'GSO ❑FedEx ❑Other <br /> Total number of coolers received 0 Temp criteria=6'C>0'C(no frozen containers) <br /> Temperature: cooler#1 20.2 °C+/-the F (i 0.2°C) = Zp.o °C corrected temperature <br /> cooler#2 °C+/-the Fi (i 0.2°C) _ °C corrected temperature <br /> I <br /> cooler#3 °C+/-the i F ( 0.2°C) _ °C corrected temperature <br /> Samples outside temp. but received on ice, /lin ours of final sampling. ❑Yes ❑No* ZN/A <br /> Custody Seals Intact on Cooler/Sample ❑Yes ❑No* 5�N/A <br /> Sample Containers Intact (OYes ❑No* <br /> Sample labels match COC ID's ®Yes ❑No* <br /> Total number of containers received match OC ! ®Yes ❑No* <br /> Proper containers received for analyses requ sted on COC MYes ❑No* <br /> Proper preservative indicated on COC/conta Hers fipr analyses requested ❑Yes ❑No* 9N/A <br /> Complete shipment received in good conditi n w th correct temperatures, containers,labels, volumes <br /> preservatives and within method specified hi Idin times. [2 Yes ❑No* <br /> *Complete Non-Conformance Receiving Sheet i the ked Cooler/Sample Review-Initials and date �2•/D•It� <br /> Comments: <br />