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VI~UJ/UU JLUq 11.10 tdA ylU LLU dUtlO <br />SantoEaas Spring, GO id+iT <br />y!g VUJ <br />JG4UP-rU <br /> • Page I a(2 <br />S~u1`IPLE RECEIPT FOR;ti1 ' <br /> ~- <br />~~orcr ~. LZ 7yr1 <br />-- ~ <br />:) Daes :.his ~rajecc requ've special handling prveodures sues ss CLP protocol? YES \p <br />I.) , .ire the _t:stady seals an the cooler intact? NA ~ ti0 <br />~ .are :F.e : is;ady seals an the sample containers inncC ~ 1'ES `" <br />=. :; _~ero s C:1ar. a[ Custody (CQC), or tithe: directive ;hiepia_ paeces pr_senC ~'s3~'6 ~C <br />j?: !3 t.`.e CCC :ar..clete". •'~ ~~ <br />Z.c!'tnquished^. Yes _ `a ~ Requested Analysis? Yes _ :to _ I I ~ <br />o) is the COC iti agreement with the samples ceeaived'• ~~ NO <br />= of Samples: Yes ~ No _ Sample ID: Yex____ No z <br />Matrix: Yes _ No _ = of Containers: Yes No _ <br />') [s eher: a-ousch sample for all «quested analvsis? ' t0 <br />3: A;e all s~-roles ~~ithin holdin_s rimes t'or requested analysis" ~p j <br />i ,~ ~ <br />`.\'crc ~:: ,a:.:p:_ :a,tainae :c.:;.ed iuwct'.- I ~ ! ~ = <br />l~) Ate s_-,pits requiring na headspace, headspace fret? _~. , ti ES <br />~ l) Do ehe so_^nples require a Fariegn Sails ?ermit Label or quarantine? ~~-YcS ~ ~ <br />! =) Da sa_:.;:)es require special d_ispasalhold eonsidentions? <br />\on•Hozardaus: Yes Na Hazardous: Yes Na Hold: manias i <br />Dei: rlCt ,•~•1.. ite ^;(crceoc=l• lL3l?): <br />k•as the clic~; :onsacted". Yts `o <br />It yes: Dace: ` <br />,i:cions taf::~ ar client instructions: <br />Signa:,ert: <br />Namc ofperson contacted: ~ <br />FTlMQA011.d 1.9t,6+ <br />t~ <br />