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APR-11-2003 10 04 <br /> P.OB <br /> � •}• tr��t�[ <br /> no-MR- <br /> -,,,�, WORK ORDER <br /> #: 0341 <br /> Cooler (ofd,,, <br /> SAMPLE RECEIPT FORM <br /> CLIENT: I�---' DATE: - - - b� <br /> TEMPERATURE—SAMPLES RECEIVED BY: <br /> CALSCIENCE COURIER: LABORATORY(Otter than Calsclence Coudo: <br /> Chiliad.cooler with temperature blank provided_ °C Temperature blank. <br /> Chilled,cooler without temperatxe blank, ( 9C IR thermometw <br /> Chilled and placed in coder vAth wet roe Ambient temperature <br /> Amblent and placed In cooler with wet ice. <br /> Ambient temperature <br /> °C Temperature blank. Initial <br /> CU3TaDY SEAL INTACT: <br /> Sample(s): Cooler No(Not Intact): Not Applicable(WA). <br /> lr�tlal: <br /> SAMPLE CONDITION: <br /> Yes No N/A <br /> Chain-of-Custody documents)received with samples.... ... ... f <br /> - Sample containerlabel(s)consistent with cu <br /> study Aspera... ... .. � ....... ....... <br /> Sample contalner(s)intact and good condition .. .. i <br /> Corned containers for analyses requested.. .... <br /> Proper presenratlon noted on sample label(s). .. `.......` <br /> VOA vial(s)flee of headspaca ... , <br /> Tedlar . . r ��r.s•.. •■ r•..��. <br /> baON)MW of condensation .. . .. . .. . .. .. r <br /> InrtW- <br /> COMMENTS: <br /> V v tC45 p3-o Zrfi eve. r ret <br /> r <br />