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I <br /> Sample Receipt Checklist STI_San Franciscle <br /> Submission #: 2002- - <br /> Checklist completed by (initials) Date /02 <br /> �-�/ 1Q2 <br /> Courier name ❑ STb San FranciscoxChent <br /> Not <br /> Custody seals intact on shipping container/samples Yes No Present <br /> Chain of custody present? Yes ✓ No <br /> Chain of custody signed when relinquished and received? Yes -`�No I <br /> Chain of custody agrees with sample labels? Yes ✓No <br /> Samples in proper container/bottle? Yes ✓No <br /> Sample containers intact? Yes No <br /> Sufficient sample volume for indicated test? Yes --No <br /> All samples received within holding time? �rf��a Yes -,"'N'o <br /> f ✓ � <br /> ContainerTremp Blank temperature in compliance(40 C±2)? Temp C Yes No <br /> Water-VOA vials have zero headspace'? No VOA vials submitted " Yes No <br /> Q)orL g <br /> comments as S small -O , M (medium - (large- v ] <br /> (if bubble is present, refer to approximate bumble size and itemize m co ( ) <br /> Water-pH acceptable upon receipt?Xyes ❑ No <br /> ❑ pH adjusted- Preservative used ❑ HNO3❑ HCI ❑ H2SO4 ❑ NaOH ❑ZnOAc <br /> For any item check-listed "No", provided detail of discrepancy in comment section below <br /> Comments n1 C L/ 61- e <br /> I <br /> Project Management [Routing for Instruction of Indicated discrepancy(les)] <br /> Project Manager (initials) Date /02 I <br /> Client contacted ❑ Yes ❑ No <br /> Summary of discussion _. A <br /> Corrective Action (per PM/Client) <br />