Laserfiche WebLink
Section 1: General lnfo;,il#"T"'^H"-Ai-A *oo S\jqs Cdrr AN)Client: <br />SAMPLE RECEIPT CHECKLIST <br />W,3""'t'xqa <br />Are custody seats present? E Yes ){.ftfo <br />E Yes tr No E On cooler / box E On samples <br />Section 2: Shipping / Custody <br />Custody seals inta <br />Shipping lnfo <br />E Outside 0.0 - 6.0'C (0.0 - 10.0'C for microbiology) (PM notified) <br />Type of ice used , KWet E Blue/Gel E None <br />E Samples received on ice directly from the field; cooling process had begun. (if checked, skip temperatures) <br />E Sample matrix doesn't require cooling (e.g. air, bulk PCB). (if checked, skip temperatures) <br />lfnocooler:observed/AdjustedTemp(.c):-l-Thermometer/lRGun <br />cooterTemp ('c) #Ltyi !J" *2,-l--#3: /-#4: /-#5: I #6: /_ <br />ARo?Jr' !,3 " <br />(_ <br />Section 3a: Condition / <br />Date Opened By (in <br />,I$to microbiology samples submitted (skip 3b)Section 3b: Microbiology Samples <br />tr Within temp range 0.0 - 10.0'C or received on ice directly from field. <br />E Adequate headspace for microbiology analysis. <br />Aruo air samples submitted (skip 3c) <br />E Sorbent Tubes E Other <br />Section 3c: Air Samples <br />El 1.41 Canisters E 6L Canisters E Tedlar Bags tr MCE Cassettes <br />Section 4: Containers / Labels / Samples YES NO N/A <br />1) Were custody papers present, filled properly, and legible?\/ <br />v2) ls the sampler's name present on the CoC? <br />3) Were containers received in good condition (unbroken / unopened / uncompromised)?{ <br />{4) Were the samples bagged? (required for microbiology samples; recommended for soil samples) <br />5) Were all of, and only, the correct samples received?,/ <br />6) Are sample labels present, legible, and in agreement with the CoC?,/ <br />7) Does the container count match the CoC? <br />,/8) Was sufficient sample volume / mass received for the analyses requested? <br />\/9) Were samples received in proper containers for the analyses requested? <br />V10) Were samples received with > U2 holding time remaining? <br />/11) Are samples properly preserved as indicated by CoC / labels? <br />t/12) Unpreserved VOAs received - lf necessary, was the hold time changed in LIMS?I13) Are VOA vials free from headspace/bubbles > 6mm? <br />E PM notifiedSection 5: Explanations / Comments <br />t lb'rDate logged By{ zt-ul <br />oate tabetea 8-0c-&Ll ev <br />Enthalpy Analytical l-0006, Rev 2: Form Version 76.1'081224 <br />I <br />9 of 76