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r <br /> . COOLER RECEIPT FORM <br /> Pro)ect: r�I Log No. <br /> Cooler receive on: and checked on y <br /> Signa <br /> Werecustody papers present? . . . . . . . . . . . . . . . . . . . . . . . . . . . t <br /> NO j <br /> Were custody papers properly filled out's . . . . . . . . . . . . . . . . . NO <br /> Were the custody papers signed? . . . . . . . . . . . . . . . . . S NO <br /> Was sufficient ice used's . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .YES NO <br /> Did all bottles arrive in good condition (unbroken) ) . . . . . . ES NO <br /> Did bottle labels match COC? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E NO <br /> Were proper bottles used for analysis indicated ) E NO <br /> Correct preservatives used? . . . . . . . . . . . . . . ES NO <br /> VOA vials checked for headspace bubbles . . . . . . . . . .� NO <br /> Note which voas (if any) had bubbles : * <br /> Sample descriptor Number of vials <br /> Aft <br /> *All VOAs with headspace bubbles have been set aside so they will not be <br /> used for analysis. . . . . . . . . . . . . . . . . . . . . .YES NO <br /> List here all other Sobs received in the same cooler <br /> Client Jab # NET log # <br /> (coolerrec) <br />