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1 <br /> Sample Receipt Checklist S7L San Francisco <br /> Submission # 2002- 08 - <br /> Checklist completed by (initials) M4 Date <br /> Couner name ❑ STL San Francisco Client <br /> I Not c/ <br /> Custody seals intact on shipping container/samples Yes No Present <br /> Cham 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/bottle? Yes ✓No <br /> Sample containers intact? Yes No <br /> ISufficient sample volume for indicated test? Yes `� No <br /> All samples received within holding time? Yes No <br /> Containerrremp 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 /> (if bubble is present, refer to approximate bubble size and itemize in comments as S (small -O), M (medium - 0)or L (large - V) <br /> 1 Water-pH acceptable upon receipt? Xryes ❑ No <br /> I 0 pH adjusted- Preservative used © HNO3 ❑ HCl ❑ HZSO4 ❑ NaOH ❑ ZnOAc <br /> For any item check-listed "No", provided detail of discrepancy in comment section below <br /> Comments v w ALJ <br /> I <br /> Project Management [Routing for Instruction of indicated discrepancy(ies)] <br /> IProject Manager (initials) Date 1 102 <br /> Client contacted ❑ Yes ❑ No <br /> ISummary of discussion <br /> I <br /> Worrective Action (per PM/Client) <br /> I <br />