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1 <br /> A; ASSOCIATED LABORATORIES <br /> i806 North Batavia—Orange, California 92868— 714-771-6900 FAX 714-538-1209 <br /> SAMPLE ACCEPTAN E CHECKLIST <br /> Section 1 / <br /> Client: V Project: <br /> Date Received: Sampler's Name: Yes No <br /> Sample(s)received in cooler: No(Skip Section 2) <br /> Shipping Information: <br /> Section 2 <br /> Was the cooler packed_ with: Ice_. _Ice Packs Bubble Wrap Styrofoam <br /> Paper None _Other <br /> Cooler or box temperature: . <br /> (Acceptance range is 2 to 6 Deg. C.) <br /> Section 3 YES NO N/A <br /> Was a COC received? <br /> Is it properly completed?QDs, sampling date and time,signature,test) <br /> Were custody seals resent? <br /> If Yes—were they intact? <br /> Were all samples sealed in plastic bags? <br /> Did all samples arrive intact?If no, indicate below. <br /> Did all bottle labels agree with COC? ID,dates and times) <br /> Were correct containers used for the tests required? <br /> Was a sufficient amount of sample sent for tests indicated? <br /> Was there heads ace in VOA vials? <br /> Were the containers labeled with correctpreservatives? <br /> Was total residual chlorine measured(Fish Bioassay samples only)? <br /> *: If the answer is no,please inform Fish Bioassay Dept. immediately. <br /> Section 4 <br /> Explanations/Comments <br /> Section 5 <br /> Was Project Mer 'feed of discrepancies: Y /A <br /> Completed By. ate: D <br /> C y' <br /> 1 <br />