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SAF-RC-047 100 & 300 Area Component of the ... - Hanford Site

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A<br />

Lionville Laboratory Incorporated<br />

SAlVIP]C E RECEIPT CHECKLIST (SRQ<br />

CL NT:^" t1 t f VA 0.c-rCo P Date:<br />

P)^rcbase Order / Project# / R C-CA7<br />

L* SOW'S/Release#r:<br />

C(Yes ONO q No Seals Comments<br />

i<br />

CVYes a No<br />

yes q No<br />

[3 Cs ONO allo Seals<br />

1 Yes 17 No<br />

Yes ONO<br />

Cf 9. All samples on coc received? A Yes ONO<br />

ll<br />

samples<br />

Yes ONO<br />

rYa q No<br />

Yes q No<br />

a Yes a No 94A<br />

a Yes ONO 94A<br />

Yes 13 No<br />

t^^ Ola<br />

LvLT Batch # : Sample Custodian:<br />

0(-0 lSO<br />

NOTE: EXPLA IN ALL DISCREPANCITS<br />

1. Samples Hand De livered<br />

2. Custody seals on coolers or shipping<br />

container intact, signed and dated?<br />

3. Outside <strong>of</strong> coolers or shipping containers are<br />

free from damage?<br />

4. All expected paperwork received (coc and<br />

o<strong>the</strong>r client specific information) sealed in<br />

plastic bag and easily accessible?<br />

5. Samples receivoled r ambient?<br />

MR.<br />

6. Custody seals on sample containers intact,<br />

signed and dated?<br />

7. coc signed and dated?<br />

8. Sample containers are intact?<br />

received on coc?<br />

10. All sample label information matches coc?<br />

11. Samples properly preserved?<br />

12. Samples received within hold t imes?<br />

Short holds taken to wet lab?<br />

13. VOA, TOC, TOX free <strong>of</strong> hesdspaee?<br />

14. QC stickers placed on bottles.designated by<br />

client?<br />

15. Shipment meets LvLI Sample Acceptance<br />

Policy? (Identify all bottles not with in<br />

policy. See reverse side for po licy)<br />

16. Proje ct Manager contacted concerning<br />

discrepancies? aame/date (or samples<br />

outside criteria)<br />

SR-0o2•B<br />

V^<br />

eX<br />

a Yes ONO ,p No<br />

/ Discrepaeties<br />

Airbill# ' 1 ge3 b'1-1 I ")-k<br />

Temp 1. 8 °C Cooler # EK4 - 63 • 41^17<br />

ee0eeoo66

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