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Quanterra 6W V S 014488
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Condi ti on Upon Receipt Variance Report
St. Louis Laboratory
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Client. _ Daze:_
Project No: -Sz) 2- Initiated by: oz,
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Shipper/No: A i r b• rrt C RFA/COC Numbers: l Q y L4
Condition/Variance (Check all that apply):
1. q Sample received b roken leaking.
2. q Sample received without proper prese rv ative.
q Cooler temperature not within 4C ± 2C
q pH
q other:
Record temperature:
3. q Sample received in improper con ta iner.
4. q Sample received without proper paperwork. Explain:
5. q Paperwork received without sample.
6. q No sample ID on sample con tainer.
7. q Custody tape disturbed broken/missing.
q No variances were noted during sample receipt. Cooler
/
Login No.: / ^7/9'
8. q Sample ID on con tainer does not match sample ID
on paperwork. Explain:
9. q III coolers on airbill not received with shipment.
10. q Other (explain below!:
Temperature Upon Receipt:
Notes: C^ ' /, 5 ^— CJrt ^G(/t-e..s, So /cJl-I
Corrective Action:
A F C 0 1
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q Client's Name: Informed verbally on: By:
q Client's Name: Informed in writing on: By:
q Sample(s) processed "as is".
q Sample(s) on hold unt il : If released. notify
Sample Control Supe rvisor Review: (or desienat Date
Project Management Review: (A— 71 G.,i^,— Date: 3 — If — ^.3
SL-ADMIN-0004. Rev¢ed 1121;95
SIGNED ORIGINAL xIL:ST BE RETAI N-ED IN THE PROJECT FILE
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