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SAMPLE RECEIPT CHECKLIST '6 <br /> Section 1: Login# _I 3&0 c(3 Client: �-"J� g I\ r U <br /> Date Received:U61-0-4> Project: ENTHALPY <br /> Section 2: Shipping info(if applicable)_{ iF= '7720 6,?6T `lin <br /> Are custody seals present? )Z(No,or❑Yes. If yes,where? ❑on cooler,❑on samples,❑on package <br /> ❑Date: How many ❑Signature,❑Initials,❑None <br /> Were custody seals intact upon arrival? ❑Yes ❑No ❑ N/A <br /> Samples received in a cooler? ❑ Yes,how many? XNo(skip Section 3 below) <br /> If no cooler Sample Temp(°C): ?-0-0 using IR Gun# ❑ B,or'�l C <br /> ❑Samples received on ice directly from the field.Cooling process had begun <br /> If in cooler:Date Opened t// �d By(print) AAA6 (sign) <br /> Section 3: Important:Notify P4 if temperature exceeds 6"C or arrive frozen. <br /> Packing in cooler:(if other,describe) <br /> ❑Bubble Wrap,❑Foam blocks,❑Bags, ❑None,❑Cloth material,❑Cardboard,❑Styrofoam, ❑Paper towels <br /> ❑Samples received on ice directly from the field.Cooling process had begun <br /> Type of ice used: ❑ Wet, ❑Blue/Gel, ❑None Temperature blank(s)included? [] Yes, ❑ No <br /> Temperature measured using ❑Thermometer ID: or IR Gun# ❑ B ❑ C <br /> Cooler Temp(`C):#1: ,#2: ,#3: ,#4: #5: #6: #7: <br /> Section 4: YES NO N/A <br /> Were custody papers dry,filled out properly,and the project identifiable .� <br /> Were Method 5035 sampling containers present? <br /> If YES,what time were they transferred to freezer? <br /> Did all bottles arrive unbroken/unopened? <br /> Are there any missing/extra samples? <br /> Are samples in the appropriate containers for indicated tests? <br /> Are sample labels present,in good condition and complete? <br /> Does the container count match the COC? <br /> Do the sample labels agree with custody papers? <br /> Was sufficient amount of sample sent for tests requested? / <br /> Did you change the hold time in LIMS for unpreserved VOAs? <br /> Did you change the hold time in LIMS for preserved terracores? <br /> Are bubbles>6mm present in VOA samples? <br /> Was the client contacted concerning this sample delivery? <br /> If YES,who was called? By Date: <br /> Section 5: YES NO N/A <br /> Are the samples appropriately preserved? (if N/A,skip the rest of section 5) <br /> Did you check preservatives for all bottles for each sample? <br /> Did you document your preservative check? <br /> pH strip lot# pH strip lot# ,pH strip lot# <br /> Preservative added: <br /> ❑H2SO4 lot# added to samples on/at <br /> ❑HCL lot# added to samples on/at <br /> ❑HNO3 lot# added to samples on/at <br /> ❑NaOH lot# added to samples on/at <br /> Section 6: <br /> ExxplljanationsA/nCfo�mments: S 1 P,cJ , ©1 J-Ie4a,1 S if, <br /> Date Logged in -0 co, By(print) 6,A&& (sign) <br /> Date Labeled l (Q By(print) (sign) <br /> Enthalpy Analytical-Berkeley Rev.15.1,09/13/2019 <br /> 5of27 <br />