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Uri/Z4/ZOOS 15:20 HAS 415 228 5450 BARG COFFIN LEWIS TRAPP IA024 <br /> MRY-22-2002 10:17 , 'RLSCIENCE . 714 894 7501 P.15/15 <br /> 4��Lrebers�oism <br /> .ia. Inc WORK ORDER At: DZ-F <br /> 01 R- ® Q P M <br /> Gaoler_L of_L <br /> SAMPLE RECEIPT FORM <br /> CLIENT: DATE: D5 6 O 2. <br /> TEMPERATURE—SAMPLES RECEIVED BY: <br /> CALSCIENCE COURIER: LABORATORY(Other than Catecience Courter): <br /> Chilled,cooler with temperature blank provided. °C Temperature blank. <br /> Chilled,cooler without temperature blank. °C IR thermometer. <br /> Chilled and plaoed In cooler with wet foe. Amblent temperature. <br /> Ambient and placed in cooler with wet ice. <br /> Ambient temperatura. <br /> °C Temperature blank. InttiaC fit! <br /> CUSTODY SEAL INTACT: <br /> SampSe(s): Cooler N No(Not intact) : Not Applicable(NIA): <br /> Initial: <br /> SAMPLE CONDITION: <br /> Yea No NIA <br /> Chain-or-Custody document(s)received with samples....................... . .... <br /> Sample container label(s)consistent with custody papers................... <br /> Sample cooter ner(a)intact and good condition................................. : .. ... <br /> Correct corttelntus for analysers requested... ............... ... ... <br /> Proper preservation noted on sample label(s).. ... ..... <br /> VOA via(s)free of headepace. ......... .... .. . .... ... .... <br /> Tedlar bag(s)free of condensation......:f...:., . ... ...... <br /> " InHY: 1�.1� <br /> COMMENTS: <br /> TOTAL P.15 <br />