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Trrle nt <br /> I A!5:7-{R 1011' . IIS=. <br /> Sample Receipt Checklist <br /> Client Name: Inaenium Date and Time Received: 10/25/2019 11:28:OOAM <br /> Project Name: UOP Received By: Helena Ueng <br /> Work Order No.: 1910246 Physically Logged By: Helena Ueng <br /> Checklist Completed By: Helena Ueng <br /> Carrier Name: Client Drop Off <br /> Chain of Custody(COC) Information <br /> Chain of custody present? Yes <br /> Chain of custody signed when relinquished and received? Yes <br /> Chain of custody agrees with sample labels? Yes <br /> Custody seals intact on sample bottles? Not Present <br /> Sample Receipt Information <br /> Custody seals intact on shipping container/cooler? Not Present <br /> Shipping Container/Cooler In Good Condition? Yes <br /> Samples in proper container/bottle? Yes <br /> Samples containers intact? Yes <br /> Sufficient sample volume for indicated test? Yes <br /> Sample Preservation and Hold Time(HT) Information <br /> All samples received within holding time? Yes <br /> Container/Temp Blank temperature in compliance? Temperature: 23.0 °C <br /> Water-VOA vials have zero headspace? No VOA vials submitted <br /> Water-pH acceptable upon receipt? N/A <br /> pH Checked by: N/A pH Adjusted by: N/A <br /> Comments: <br /> 483 Sinrlgir Front,9ge Rd_, MiIpi;as, CA 95435 I le?:408.263.5258 I iax:43 8..263.8293 I www-to rrent386_Com <br /> Total Page Count: 21 Page 19 of 21 <br />