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SAMPLE RECEIPT CHECKLIST ^ o <br /> Section 1: Login# `7 hV 7[6 Client: l 0)skl <br /> ENTHALPY <br /> Date Received: 2 i 2 I Project: <br /> Section 2: Shipping Info(if applicable) <br /> Are custody seals present? o,or❑Yes. If yes,where? ❑on cooler,❑on samples,❑on package <br /> ❑Date: How many ❑Signature,❑Initials,❑None <br /> Were custody seals Intact upon arrival? ❑Yes ❑No ❑ N/A <br /> Samples received in a cooler? [ Yes,how many? ❑No(skip Section 3 below) <br /> If no coolerple Temp(°C): using IR Gun# ❑ B,or [IC <br /> amples received on ice directly from the field.Cooling process had begun <br /> If In cooler:Fate Opened 2 x,312 By(print) (sign <br /> Section 3: Important:Notify PM If temperature exceeds 6'C or arrive frozen. <br /> Packing in cooler:(if other,describe) <br /> ❑Bubble Wrap,❑Foam blocks,❑Bags, [I None,❑Cloth material, 11 Cardboard,❑Styrofoam, ❑Paper towels <br /> Samples received on ice directly from the field.Cooling process had begun <br /> ype of ice used: ❑ Wet, ❑Blue/Gel, ❑None Temperature blank(s)included? ❑ Yes, ❑ No <br /> Temperature measured using ❑Thermometer ID: or IR Gun# ❑ B ❑ C <br /> Cooler Temp("C):#1: ,#2: ,#3: ,44: #S: #6: #7: <br /> Section 4: YES NO N/A <br /> Were custody papers dry,filled out properly,and the project identifiable <br /> Were Method 5035 sampling containers present? <br /> If YES,what time were they transferred to freezer? <br /> Did all bottles arrive unbroken/unopened? <br /> Are there any missing/extra samples? <br /> Are samples In the appropriate containers for Indicated tests? <br /> Are sample labels present,in good condition and complete? <br /> Does the container count match the COC? <br /> Do the sample labels agree with custody papers? <br /> Was sufficient amount of sample sent for tests requested? <br /> Did you change the hold time in LIMS for unpreserved VOAs? <br /> Did you change the hold time in LIMS for preserved terracores? <br /> Are bubbles>6mm present in VOA samples? <br /> Was the client contacted concerning this sample delivery? <br /> If YES,who was called? By Date: <br /> Section 5: YES NO N/ <br /> Are the samples appropriately preserved? (If N/A,skip the rest of section 5) <br /> Did you check preservatives for all bottles for each sample? <br /> Did you document your preservative check? <br /> pH strip lot# pH strip lot# pH strip lot# <br /> Preservative added: <br /> ❑H2SO4 lot# added to samples on/at <br /> ❑ HCL lot# added to samples on/at <br /> ❑HNO3 lot# added to samples on/at <br /> ❑NaOH lot# added to samples on/at <br /> Section 6: <br /> Explanations/Comments: <br /> Date Logged in z ZBy(print) (sign) <br /> Date Labeled z �7-4 �� By(print) z (sign) <br /> Enthalpy Analytical-Berkeley Rev.15.1,09/13/2019 <br /> 5of48 <br />