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2021-07-13_GENERAL DOCUMENTS - M1980085
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2021-07-13_GENERAL DOCUMENTS - M1980085
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Last modified
1/11/2025 4:12:56 AM
Creation date
7/14/2021 6:17:39 AM
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Template:
DRMS Permit Index
Permit No
M1980085
IBM Index Class Name
GENERAL DOCUMENTS
Doc Date
7/13/2021
Doc Name
RE: Spill
From
Kilgore Companies
To
DRMS
Email Name
ACY
Media Type
D
Archive
No
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ALS Group, USA <br /> Sample Receipt Checklist <br /> Client Name: ECOS Date/Time Received: 03-Jun-21 09:30 <br /> Work Order: 21060416 Received by: DS <br /> Checklist completed by Diane Shaw 04-Jun-21 Reviewed by: Chad WheltOn 04-Jun-21 <br /> .Signature Date eSignature Date <br /> Matrices: Soil <br /> Carrier name: Fed Ex <br /> Shipping container/cooler in good condition? Yes d❑ No ❑ Not Present ❑ <br /> Custody seals intact on shipping in container/cooler? Yes d❑ No ❑ Not Present El <br /> Custody seals intact on sample bottles? Yes ❑ No ❑ Not Present ❑d <br /> Chain of custody present? Yes d❑ No ❑ <br /> Chain of custody signed when relinquished and received? Yes © No ❑ <br /> Chain of custody agrees with sample labels? Yes No ❑ <br /> Samples in proper container/bottle? Yes No ❑ <br /> Sample containers intact? Yes © No ❑ <br /> Sufficient sample volume for indicated test? Yes © No ❑ <br /> All samples received within holding time? Yes No ❑ <br /> Container/Temp Blank temperature in compliance? Yes 0 No ❑ <br /> Sample(s) received on ice? Yes ❑ No❑ <br /> Temperature(s)/Thermometer(s): 5.4/5.4 c IR1 <br /> Cooler(s)/Kit(s): <br /> Date/Time sample(s) sent to storage: 6/4/2021 7:28:11 AM <br /> Water-VOA vials have zero headspace? Yes LJ No No VOA vials submitted ❑� <br /> Water-pH acceptable upon receipt? Yes ❑ No❑ N/A <br /> pH adjusted? Yes ❑ No ❑ N/A <br /> pH adjusted by: <br /> Login Notes: <br /> --------------------------------------------- <br /> -------------------------- <br /> Client Contacted: Date Contacted: Person Contacted: <br /> Contacted By: Regarding: <br /> Comments: <br /> CorrectiveAction: —� <br /> SRC Page 1 of 1 <br />
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