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Service Request No: L060� Client: 3 AW <br />Sample(s) delivered by: Client CAS Emp After Hours DHL <br />Golden State Overnight Fed X UPS V Other Courier <br />Chain of Custody filled out accurately? Yes --�L No (See Comments) <br />Appropriate sample volume and containers? Yes No (See Comments) <br />Sufficient labeling on container(s) ? Yes No (See Comments) <br />Container(s) supplied by CAS? Yes No (See Comments) <br />Custody seal(s) intact? N/A_ Yes No (See Comments) <br />Trip Blank(s) received Yes No <br />If Trip Blank was supplied by CAS, record serial # -TB_ <br />Temperature of sample(s)//cooler °C Temp Blanlo <br />r N(Circle One) <br />Voa's Marked Preserved? Yes of No Filled Properly? Yes No (See Comments) <br />Preserved Bottles Requiring pH check(s)? Yes J Appropriate Preservation? Yes ✓ No <br />RUSH Turn around time? Yes. Notified Date & Time <br />Short Hold -Time Analysis (check all that apply) <br />ASAP Res Cl D.0 Flash Diss S2= Ferrous Fe <br />24HR pH Odor Cr+6 <br />48HR BOD Color MBAS Nitrate <br />Nitrite 0-PO4 Sett Sol Turbidity <br />72HR Vapors <br />Notified Date & Time <br />Container(s) received and their preservative(s): <br />--1-� _y = 3-4ci mi %kWeL) <br />IAL R-Nf) <br />c -500r11 <br />I -r�-srvt t <br />Comments <br />-5 6-6 z a-4 o M1 d o A -t kLl) <br />Initials, Date, Time �- rAsr forms\cooler.doc Rev. 2/25/02 <br />C <br />r] <br />J <br />r <br />L <br />r <br />C <br />r <br />C <br />