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Service Request No: P070Q Client: 6 `Gc } <br />Sample(s) delivered by: Client CAS Emp After Hours DHL <br />Golden State Overnight Fed X UPS ✓ Other Courier <br />Chain of Custody filled out accurately? Yes ✓ No (See Comments) <br />Appropriate sample volume and containers? Yes No (See Comments) <br />Sufficient labeling on container(s) ? Yes a% No (See Comments) <br />Container(s) supplied by CAS? Yes ✓ No (See Comments) <br />Custody seal(s) intact? N/A V"' Yes No (See Comments) <br />Trip Blank(s) received N/A Yes i✓ No <br />Trip Blank was supplied by CAS Yes V-" No <br />Record serial # -TB-_A___ <br />Temperature of sample(s)/cooler °C Temp Blank Y r N (Circle One) <br />Voa's Marked Preserved? Yes ✓ No Filled Properly? Yes 1 -/No (See Comments) <br />Preserved Bottles Requiring pH check(s)? Yes V Appropriate Preservation? Yes v No <br />RUSH Turn around time? Yes Notified Date & Time <br />Short Hold -Time Analysis (check all that apply) <br />ASAP <br />Res Cl <br />D.0 Flash <br />Diss S2- Ferrous Fe F & P <br />24HR <br />pH <br />Odor Cr+6 <br />48HR <br />BOD <br />Color MBAS <br />Nitrate VIII <br />Nitrite <br />O-PO4 Sett Sol <br />Turbidity <br />72HR <br />Vaporskw <br />Notified <br />Date& Time jig 6� <br />/'Q <br />Container(s) received and their preservative(s): <br />Yam/ V,005 Can <br />/IWO <br />LA6 10/1-501/ <br />Comments f -ZI4— I A/ <br />n <br />D <br />[1 <br />A <br />Initials, Date, Time s' ~ / v / M0\L0GFORMS\C00LER.DOC <br />11 <br />