Laserfiche WebLink
ALS Environmental-Fort Collins <br /> CONDITION OF SAMPLE UPON RECEIPT FORM <br /> ALS <br /> Client Name/ID: Telesto Workorder No: 2103123 <br /> Project Manager: KMO Initials: RGA Date: 03/04/2021 <br /> i.Are airbills/shipping documents present and/or removable? ❑✓ Drop-❑ YES NO <br /> 2.Are custody seals on shipping containers intact? ❑✓ No— YES NO- <br /> 3.Are custody seals on sample containers intact? 0 NONE YES NO• <br /> 4. Is there a COC(chain-of-custody)present? �✓ YES NO- <br /> 5. Is the COC in agreement with samples received? (IDs,dates,times,#of samples,#ofcontainers,matrix,requested analyses,etc.) [j] YES NO• <br /> 6.Are short-hold samples present? ❑ YES�✓ NO <br /> 7.Are all samples within holding times for the requested analyses? YES❑ NO- <br /> 8.Were all sample containers received intact? (not broken or leaking) YES❑NOxx <br /> 9. Is there sufficient sample for the requested analyses? YES NO• <br /> io.Are samples in proper containers for requested analyses?(form2so,Sample Handling Guidelines) �✓ YES❑NO- <br /> ii.Are all aqueous samples preserved correctly,if required? N/A❑✓ YES NO• <br /> 12.Were unpreserved samples pH checked,if required? Z N/A YES NO <br /> 13.Are all samples requiring no headspace(VOC,GRo,RSM/MEE,radon)free of bubbles>6 mm in diameter? ❑✓ N/A❑ YES NO <br /> 14.Were the samples shipped on ice? ❑✓ YES NO <br /> is.Were cooler temperatures measured at 0.1-6.0°C? IR gun used• #3 YES NO <br /> Cooler#: 1 <br /> Temperature(°C): 2.4 <br /> #of custody seals on cooler: 0 <br /> External uR/hr reading: <br /> Background Whir reading 0 Were external mR/hr readings 5 two times background and within DOT ❑ N/A 2] YES NO <br /> acceptance criteria?(If no,see Form 008) <br /> Please provide details below for'NO'responses in gray boxes above-for 2 thru 5&7 thru 12,notify PM&continue w/login. <br /> All client bottle ID's vs ALS lab ID's double-checked by: RGA <br /> If applicable,was the client contacted? ❑YE ONO Contact Name: Date: <br /> Project Manager Signature/Date: 3 L ' <br /> Form 201r30.xls +IR Gun#3,VWR SN 170647571 <br /> (06/04/2020) +IR Gun#5,VWR SN 192272629 <br /> 7 of 31 <br />