Laserfiche WebLink
1. <br />Does this project require any special handling in addition to standard ALS procedures? <br />YES <br />NO <br />Are custody seals on shipping containers intact? <br />NONE <br />YES <br />NO <br />s <br />Are Custody seals on sample containers intact? <br />NON <br />YES <br />WS <br />NO <br />NO <br />4 <br />Is there a COC (Chain -of - Custody) present or other representative documents? <br />5- <br />Are the COC and bottle labels complete and legible? <br />\ ES <br />N() <br />6- <br />7 - <br />Is the COC in agreement with samples received? (IDs, dates, times, no. of samples, no. of <br />containers, matrix, requested analyses, etc.) <br />YES <br />NO <br />NO <br />Were airbills / shipping documents present and/or removable? <br />DROP OFF <br />ES <br />8 <br />Are all aqueous samples requiring preservation preserved correctly? (excluding volatiles) <br />'f! <br />YES <br />NO <br />9 <br />Are all aqueous non - preserved samples pH 4 - 9? <br />NiA <br />Y ES <br />Y <br />YES <br />NO <br />NO <br />NO <br />10 <br />Is there sufficient sample for the requested analyses? <br />11 <br />Were all samples placed in the proper containers for the requested analyses? <br />'E) <br />12 <br />Are all samples within holding tunes for the requested analyses? <br />c . <br />NO <br />13 <br />14 <br />Were all sample containers received intact? (not broken or leaking, etc.) <br />YES) <br />NO <br />NO <br />,NO) <br />Are all samples requiring no headspace (VOC, GRO, RSK/NIEE, Rx CN /S, radon) <br />headspace free? Size of bubble: < green pea > green pea <br />N� <br />YES <br />IS <br />Do any water samples contain sediment? Amount <br />Amount of sediment: dusting moderate heavy <br />NIA <br />YES <br />16 <br />Were the samples shipped on ice? <br />' ES <br />NO <br />17 <br />Were cooler temperatures measured at 0.1- 6.0 ° C? 1R gun used *: #2 <br />O NI D • <br />YES <br />NO <br />Cooler #: 1 <br />Temperature ( 5,1 <br />No. of custody seals on cooler a <br />DOT Survey, <br />Acceptance <br />mr« matron <br />External Itlt/ltr reading: 3 <br />Background µR/hr reading: 1 ‘ <br />Form 01)8.) <br />Were external pitthr readings 5 two times background and within DOT acceptance criteria? i'ES / NO /NA (11' no, sec <br />ALS <br />Client: <br />Project Manager: <br />ALS Environmental - Fort Collins <br />CONDITION OF SAMPLE UPON RECEIPT FORM <br />Additional Information: PROVIDE. DETAILS BELOW FOR A NO RESPONSE TO ANY QUESTION ABOVE, EXCEPT 81 AND i 16. <br />If applicable, was the client contacted? YES / NO / (IA n tact: <br />Project Manager Signature / Date: —AA <br />0 <br />Workorder No: l L C' 1 —1 3 4 <br />'IR Gun #2: Oakton, SM29922500201 -0066 <br />Form 20ir24.xls (06/04(20121 '1R Gun #4: Oakton, SN 2372220101-0002 <br />Initials: CDT I)ate: `) - i 1 - l )- <br />Daterfime. <br />Plowd"^ t^f 54 <br />