NYC 9/11 Public Portal Document
EHI, Inc. 973-729-5649 p.2O
Friday. March 01. 2002 10:34 AM
Fob.25 02 OLs18p PSC Rnaliftieal Services 8103219667 P.3
PSC Analytical Services
Sample Receipt Checkfet
CifentName ENVIRONMENTAL HEALTH I Date and Time Receive 2/21/2002 9;30:00 AM
Wenk Order Ntst^ R02D2D734 Received Oy PRS
Checklist completed 0 Reviewed by
' kiKals T
Matrix Canter name F^Es
Shipping cxmtainer/cooter in good condiBon? Yes 2 noD NotPreoen tJ
Custody seals intact on shippping oontateer/cooler? Yes □ NoO Not Prasen SC
Custody seals intact on sample bottles? Yes □ NoO Not Presan
Oiaifl of custody present? Yes 1^ NoCl
Chain of custody signed whan reilntjuished and received? Yes 53 NoO
Chain of custody agrees with sample taOels? Yes 2 NoO
Sampiee in proper container/bolllo? Yes 0 NoD
Sample rantalners intact? Yes 53 NoO
Cufllcient sample volurro for tncHcafed test? Yes 2 woD
AS samploo received wilhin hoidins time? Yes @ NoD
ContainerfTemp Blank temperature in compliance? Yes 53 Noll'
Water ~ VOA vials have zero headspace? No VOA vials submitted E Yes O No O
Water - pH acceptable upon receipt? Yes 133 noD
Adjusted? Checkedb
Any No and/or NA {not applicable} response must be riaiailad in the comments section b
CDent contacted Oats contacted: Person contacted
Contacted by: Regarding
Comments;
Corrective Action
1 1
NYC-WTC_000154806
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