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Figure 1<br />

SAMPLE CHECK-IN LIST<br />

DateTme Received: 3C//11'0 ICES 14 t /^ SG#:_ ^ 2 ^^^^<br />

Work Order Number. 0 t ^^`T SAF #-<br />

Shipping Container 10: ^ C ^ h h6^ Chain of Custody # L - (L<br />

1. Custody Seals on shipping container intact?<br />

2. Custody Seals dated and signed?<br />

3. Chain•of-Custody record present?<br />

4. Cooler temperature<br />

5.<br />

Vermiculite/packing materials is<br />

6. Number of samples in shipping container.<br />

7. Sample holding times exceeded?<br />

8. Samples have:<br />

J tape hazard labels<br />

_custody seals app ro priate sample labels<br />

9. Samples are:<br />

V .n good condition leaking<br />

broken have air bubbles<br />

10. Where any anomalies identified in sample receipt? Yes f 1 No [ -,/<br />

11. Description of anomalies (include sample numbers):<br />

Sample Date:<br />

Telephoned To: On gy<br />

N,<br />

PFSH-SOW-93-0003<br />

Revision 5<br />

Yes [+40 11<br />

Yes ( `el^4o (1<br />

Yes ( No [ 1<br />

Wet [ 1 C ry tTr G-( ,<br />

Yes (I No (I<br />

LU9`

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