Laserfiche WebLink
Applied P & Ch Laboratory <br /> 13760 Magnolia Ave.,Chino CA 91710 <br /> Tel: (909)590-1828 Fax: (909)590-1498 Sample Receiving Checklist <br /> APCL ServiceID: - Tient a e/Project-ZE M&.�MA!E Ov.1PRt- <br /> 1. <br /> Sample Arrival <br /> Date/Time Received 3 al b 11 Date/Time Opened Z' D� � By (name): <br /> Custody Transfer: Client ❑Golden State ❑ UPS ❑ US Mail [--] FedEx <br /> 2. Chain-of-Custody (CoC) <br /> With Samples? ❑Faxed? LAClient has Co ;,? igned, dated? By: <br /> WE Project ID? Analyses Clear? ❑ Hold Samples' on Hold # Received <br /> -XICoC/Docs Zip-Locked nder lid? ❑Compos.#: _ Samples OK? <br /> ❑ Discrepancies? ❑Client notified? ❑ Response (atta_h docs): <br /> 3. Shipping Container/Cooler <br /> Cooler Used? # of�_Cooled by: Ice ❑ Blue Ice ❑Dry Ice EJNone <br /> - Terri p °C �� <br /> (Cooler temperature measured from temp blank if present, otherwise measured from the cooler). <br /> Cooler Custody Seal? ❑Absent ❑ Intact ❑Tampered? <br /> 4. Sample Preservation <br /> ❑ pH <2 ❑ pH >12 <br /> If Not, pH - Preserved by: ❑ Client ❑APCL ❑Third Party <br /> 5. Holding-time Requirements ' <br /> ❑ pH 24hr ❑ BACT 6/24hrCrVI 24hr -E] NO3 48hr 11BOD 48hr <br /> ElC12 ASAP ❑Turbidity 48hr DO ASAP ❑ Fe(Il) ASAP <br /> ❑ HT Expired? ❑Client notified? <br /> 6. Sample Container Condition <br /> ❑ Intact? ❑ Broken? ❑ Documented? Number: <br /> Type: plastic EJ 11 <br /> ❑Tube: brass/SS EJTedlar Bag <br /> Quantity OK? 11Leaking? ElAnoma •? <br /> Caps tight? El Air Bubbles? El Anomaly? <br /> Labels: ique ID? Date/Time ❑ Preserved? <br /> 7. Turn Around Time <br /> ❑'RUSH TAT: 4std (7-10 days) ❑Not Marked <br /> 8. Sample Matrix <br /> EJ Drinking H2 Other Liq ElSoil ❑Wipe El Polymer ❑Air ❑Other: <br /> El Ground H2O Sludge ❑ Filter ❑Oil/Petro ❑Paint ❑W. Water ❑ Extract ❑ Unknown <br /> 9. Pre-Login Check List Completed & OK? <br /> 64 ALL OK? (if not, attach ocs) ❑ Client Contact? (Name: )Date/Time: <br /> Received/Checked by: AI— Date: 21 Mar 2001 Time: 7:51 a.m. <br /> BHT: Samples must be analyzed for results to reflect total concentrations. Results generate:outside required of holding times are considered minimal <br /> values and may be used to define waste as hazardous but not as non-hazardous. <br /> DocumentFile: lne 1Ae:files)tmprcl.tes. <br /> 63$0 . <br />