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i <br /> i <br /> • Samle Receipt Checklist STL San Francisco <br /> I P <br /> Submission #. 2002-�� - <br /> IChecklist completed by (initials)0 Date �U 1.-26102 <br /> Courier name ❑ STL San Francisco Client <br /> Not <br /> Custody seals intact on shipping container/samples Yes No Present­SZ <br /> Chain of custody present? Yes_ No <br /> IChain of custody signed when relinquished and received? Yes ✓No <br /> Chain of custody agrees with sample labels? Yes ✓No <br /> ISamples in proper container/bottles Yes /J No <br /> Sample containers intact? Yes " No <br /> Sufficient sample volume for indicated test? Yes No <br /> All samples received within holding time? /] L.1 <br /> Yes No <br /> Container/Temp Blank temperature in compliance(40 Ci:2)? Temp !t °C Yes No ✓ <br /> 14fiter-VOA vials have zero headspace? No VOA vials submitted Yes No <br /> (if bubble is present, refer to approximate bubble size and itemize in comments as S (small -O), M (medium - 0)or L(large -- 0) <br /> Water-pH acceptable upon receipt? 0 Yes ❑ No <br /> I0 pH adjusted- Preservative used ❑ HNO3 0 HCI ❑ H2SO4 ❑ N20H ❑ZnOAc <br /> For any item check-listed "No", provided detail of discrepancy in comment section below <br /> Comments <br /> I <br /> Project Management [Routing for instruction of indicated discrepancy(les)] <br /> Project Manager (initials) Date / /02 <br /> Client contacted ❑ Yes ❑ No <br /> lSummary of discussion <br /> Wcorrective Action (per PM/Client) <br />