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' Sample Receipt Checklist STL San Francisco <br /> Submission #: 2002- a D 41 1 <br />' Checklist completed by (initials) / C Date D 1 2_0 /02 <br /> Couner name ❑ STL San Francisco I Client Not c/ <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 <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 /> IContainerfTemp Blank temperature in compliance (40 C±2)? Temp �C Yes r/ No <br /> Water-VOA vials have zero headspace? No VOA vials submitted V" Yes No <br /> I • <br /> (if bubble is present, refer to approximate bubble size and itemize in comments as S (small -0), M (medium — O) or L(large— O) <br /> IWater-pH acceptable upon receipt? ❑ Yes ❑ No <br /> ❑ pH adjusted— Preservative used ❑ HNO3 ❑ HCI ❑ H2SOA ❑ NaOH ❑ ZnOAc <br /> For any item check-listed "No", provided detail of discrepancy in comment section below <br /> Comments ��I 1 - 4" 9-v._ C-pC, �@Oc S5 ,(� e14l- 5 <br /> I <br /> Project Management [Routing for instruction of Indicated discrepancy(les)] <br /> Project Manager (initials) Date 1 102 <br /> Client contacted ❑ Yes ❑ No <br /> Summary of discussion <br /> I <br /> *Corrective Action (per PM/Client) <br /> I <br /> I <br />