Laserfiche WebLink
ME <br />® Ammu-rEST. Accutest Laboratories Sample Receipt Summary <br />LAVOnATONiLV <br />Accutest Job Number: C41951 Client: DYSERT <br />Date/ Time Received: 9/24/2015 10:00:00 AM Delivery Method: <br />Cooler Temps (Initial/Adjusted): #1: (1.9/1.9): <br />Cooler Security Y <br />1. Custody Seals Present: ❑ <br />or N Y or N <br />® 3. COC Present: .❑ ❑ <br />2. Custody Seals Intact: ❑ <br />❑ 4. Smpl Dates/Time OK © [] <br />Cooler Temoerature <br />1. Temp criteria achieved: <br />_Y or N <br />® ❑ <br />2. Therm ID: <br />IR1; <br />3. Cooler media: <br />Ice (Bag) <br />4. No. Coolers: <br />1 <br />Quality Control Preservation <br />1. Trip Blank present / cooler: <br />Y or N NIA <br />❑ ❑ <br />2. Trip Blank listed on COC: <br />❑ ❑ <br />3. Samples preserved properly: <br />© ❑ <br />4. VOCs headspace free: <br />❑ ❑ <br />Accutest Courier <br />Project: PACTIV PACKAGING <br />Airbill #`s: <br />Samole Intearity - Documentation <br />1. Sample labels present on bottles: <br />Y <br />© <br />or N <br />❑ <br />2. Container labeling complete: <br />© <br />❑ <br />3. Sample container label / COC agree: <br />© <br />❑ <br />Sample Integrity - Condition <br />1. Sample recvd within HT: <br />Y <br />W <br />or N <br />❑ <br />2. All containers accounted for: <br />© <br />❑ <br />3. Condition of sample: <br />Intact <br />Sample Intearity - Instructions <br />1. Analysis requested is clear: <br />Y <br />® <br />or N NIA <br />❑ <br />2. Bottles received for unspecified tests <br />❑ <br />66 <br />3. Sufficient volume recvd for analysis: <br />® <br />❑ <br />4. Compositing instructions clear: <br />❑ <br />❑ <br />5. Filtering instructions clear: <br />❑ <br />❑ 66 <br />A—test Laboralones 2105 Lundy Avenue San Jose, CA 95131 <br />V:408.588.0200 F: 408.588.0201 v IacwlesLCM <br />C41951.: Chain of Custody <br />Page 2 of 2 <br />MR 9of19 <br />M ^OOU-rEST. <br />C41951 ""°°""-.1 " <br />