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Sample Receipt Checklist STL San Francisco <br /> ISubmission #. 2002- - 0 143 7— <br />' Checklist completed by (initials) )054- Date I a� 102 <br /> Courier name ❑ STL San Francisco XI Client 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? Yesy' No <br /> Chain of custody agrees with sample labels? Yes ✓ No <br /> Samples in proper container/bottle? Yes No l:/ <br /> Sample containers intact? Yes No <br /> Sufficient sample volume for indicated test? Yes No <br /> All samples received within holding t,me? Yes Na <br /> ContainerlTemp Blank temperature in compliance (4°C±2)? Temp °C Yes No 0 <br /> Water-VOA vials have zero headspace? No VOA vials submitted Yes '� No <br /> It <br /> (if bubble is present, refer to approximate bubble size and itemize in comments as S (small-O), M (medium — O)or t_(large— iJ) <br /> IWater-pH acceptable upon receipt? XYes ❑ No <br /> ❑ pH adjusted— Preservative used ❑ HNO3 ❑ HCI ❑ HzSOJ ❑ NaOH ❑ ZnOAc <br /> For any item check-listed "No", provided detail of discrepancy in comment section below - <br /> Comments <br /> I <br /> I <br /> Project Management [Routing for instruction of indicated dlscrepancy(les)] <br /> IProject Manager (initials) Date 1 102 <br /> Client contacted ❑ Yes ❑ No <br /> ISummary of discussion <br /> gGorrective Action (per PM/Client) <br /> I <br />