Industrial hygiene report cover, Sept 2002

NYC 9/11 Public Portal Document

PSC Analytical Services

Sample Receipt Checklist

Client Name ATC ASSOCIATES Date and Time Receive 9/17/2002 10:20:00 AM

Work Order Numbe R02090549 Received by DMT

Checklist completed by / v C... Reviewed by Signature — Data Initials ate

Matrix: Carrier name FedEx

Shipping container/cooler in good condition? Yes L~ No ❑ Not Presen II Custody seals intact on shippping container/cooler? Yes u No a Not Presen

Custody seals intact on sample bottles? Yes ❑ No ❑ Not Presen

Chain of custody present? Yes No

Chain of custody signed when relinquished and received? Yes NoEl

Chain of custody agrees with sample labels? Yes No ❑

Samples in proper container/bottle? Yes No ❑

Sample containers intact? Yes No ❑

Sufficient sample volume for indicated test? Yes No ❑

• All samples received within holding time? Yes No ❑

Container/Temp Blank temperature in compliance? Yes No ❑

Water - VOA vials have zero headspace? No VOA vials submitted Yes ❑ No ❑

Water - pH acceptable upon receipt? Yes ❑ No

Adjusted? Checked b

Any No and/or NA (not applicable) response must be detailed in the comments section be

Client contacted Date contacted: Person contacted

Contacted by: Regarding:

Comments:

Corrective Action

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NYC-WTC 000131789