Chain of custody form, 90 Church Street, Nov 2001

NYC 9/11 Public Portal Document

• LOT RECEIPT CHECKLIST STL Sacramento

CLIENT St-tM1&til.Sk... PM O LOG >IE _ 2.t 2j00 LOTI (QUANTIMS ID) G tt "2.fn "USS QUOTES L 4-i1 q LOCATION_ ~j JA

initials Date DATE RECEIVED (O'1- 6 `al TIME RECEIVED ©01 i5 C'- to -Z. i t

DELIVERED BY DO FEDEX ❑ CA OVERNIGHT ❑ CLIENT ❑ AIRBORNE ❑ GOLDENSTATE ❑ DHL ❑ UPS ❑ BAX GLOBAL 0 GO-GETTERS ❑ STL COURIER ❑ B&B ❑ OTHER

CUSTODY SEAL STATUS ❑ INTACT ❑ BROKEN (~C] N/A CUSTODY SEAL I(S) SHIPPPING CONTAINER(S) ❑ STL CLIENT ❑ N/A . TEMPERTURE RECORD (IN °C) IR 10 2 ❑ OTHER /g~ COC I(S) TEMP TURE BLANK AM IE EMPERATURE LLECTOR.S NAME: 0 Verified from COC [ Not on COC

pH MEASURED ❑ YES ❑ ANOMALY N/A LABELED BY.......................................................................................... LABELS CHECKED BY........................................................................... SHORT HOLD TEST NOTIFICATION SAMPLE RECEIVING WETCHEM 91 N/A

❑ METALS NOTIFIED OF FILTER/PRESERVE VIA VERBAL & EMAIL f6 N/A

COMPLETE SHIPMENT RECEIVED IN GOOD CONDITION WITH ❑ N/A APPROPRIATE TEMPERATURES, CONTAINERS, PRESERVATIVES ❑ Clouseau ❑ TEMPERATURE EXCEEDED (2 °-6 °CT N/A ❑ WET ICE ❑ BLUE ICE ❑ GEL PACK ❑ PM NOTIFIED 0 NO COOLING AGENTS USED • Notes:

- LEAVE No SPAt'.FS RI Atli t tcr. •wte• tc Nnr ADDI &PAALE_ INITIAL AND DATE ALL •NIA ENTRIES. 0A185 WOO REEK NYC-WTC 000124765