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F%jwI 1<br />

SAMPLE CNECX-IN LIST<br />

CaterTime Received: . ^ 151 SG*<br />

wcnc Order Number L' ? i ( ^' ^(GI Say 1R- C^^ ^I<br />

Shipping Container IDk l SJ^ Chin dCustody;<br />

RFSHSOw-93-0003 -<br />

Revision<br />

^1<br />

(1 ^^' l<br />

1. Custody Sealsaod*Ong , I i ktar Yes IC II<br />

2 Custody Seals d*d and signed? Yes K,40 No I 1<br />

3. Chain-of-Custody recatd presenO<br />

GC<br />

Yes I 1<br />

4. Caalet temperaftae<br />

5. Vennici telpad* materials is Wet ( ; 3rY ( l<br />

6.<br />

Number of samples in shipping corainer<br />

7. Sample holding Imes exceeded? Yes [ ; No I 1<br />

8. Sammhave<br />

tape hazard Labels<br />

seats appropriate sample labels<br />

9. samples are_<br />

_SLm good wnd ition lealdng<br />

broken _ have air bubbles<br />

10. Where any anomalies identified in sample receipt?<br />

11. Cescsiption of mana lies (nude sample numbers)_<br />

Sample Custcdianllabaatorl '^ Date_<br />

Yes I 1 No I<br />

Telephoned To: Ongy<br />

IA<br />

60S;

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