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

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Lionvi ll<br />

e Laborato ry Incorporated<br />

SAMPLE RECEIPT CHECKLIST (S<strong>RC</strong>)<br />

(<br />

CLIENT: `-NaaRr^ oc,^ Date:`<br />

Order / Project# /<br />

<strong>SAF</strong># w# / Release #: <strong>RC</strong> o' \^<br />

v Batch 9: rl,N ) n ,\,<br />

1. Samples Hand<br />

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

container intact, signed and dated?<br />

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

free from damage?<br />

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

o<strong>the</strong>r c li<br />

ent speci fic information) sealed in<br />

plastic bag and easily accessible?<br />

5. Samples receiv cool r ambieut? y Q<br />

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

signed and dated?<br />

7, coc signed and dated?<br />

8. Sample containers are intact?<br />

9. All samples on coc received? A ll samples<br />

received on coc?<br />

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

11. Samples properly preserved?<br />

12. Samples received within hold times?<br />

Short holds taken to wet lab?<br />

SR-002-B<br />

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

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

client?<br />

15. Shipment meets LvLI Sample Acceptance<br />

Policy? (Identify all bottles not within<br />

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

16. Project Manager contacted concerning<br />

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

outside criteria)<br />

vLl<br />

EXPLAIN ALL<br />

/<br />

O No<br />

/Q Yes q No<br />

17 3es 0 No<br />

O No Sash Comments<br />

Tetup 7 .3 IC<br />

S<br />

^d Yes O No O No seats<br />

1 93<br />

11 Yes<br />

/^Y4<br />

I(Yea<br />

Yes<br />

Yes<br />

O Yes<br />

Oyes<br />

O Yes<br />

Ye<br />

U Yes<br />

Sample Custodian:<br />

ONO<br />

O No<br />

O No<br />

ONO<br />

O No<br />

O No<br />

O No /^11`NlA<br />

ONO 94 A<br />

ONo<br />

Airbill# '7 q a7 °^ 5 OS<br />

ONo 0 N<br />

Diseeepsoeks<br />

Cooler# SAW - 1a^<br />

000009027

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