ARCHIVED REPORTS XR0003339 - Laserfiche WebLink

Home Browse Search

' TESTAMERICA INC.-NASHVILLE COOLER RECEIPT FORM ' Client ��G c ,` P ,`�,�, BC# J ICooler Received On: 11/15/02 And Opened On. 11/15102 By: Shawn Gracey �— ' (Signature) 1. Temperature of Cooler when opened Degrees Celsius ' 2. Were custody seals on outside of coolers ... ... . ...... .. . ...YES N N/A a If yes, how many,what kind and where (FRONTBACK/SIDE) ' 6 Were the seals intact,signed, and dated correctly?.. . . . . . .YESNOS NIA 3. Were custody seals on containers and intact?.................................... O ES NIA 4. Were custody papers inside cooler? . .... . . .... .. ES \NO N/A 5. Were custody papers properly filled out(ink,signed,etc)?... ...... .. . . . �1NO N/A 6. Did you sign the custody papers in the appropriate place?. . . . .. . 6YENO N/A 7 What kind of packing material used? Bu blewrap Peanuts Vermiculite Other None 8. Was sufficient ice used (if appropriate)? ... . . . .. .. .. . ..YE NO N/A 9 Did all bottles arrive in good condition( unbroken)?.. . , ENO N/A 10 Were all bottle labels complete (#,date,signed,pres,etc)? .. . . .. .. .. S.YES) NO N/A 11 Did all bottle labels and tags agree with custody papers? .. ,.. . . .. NO NIA ' 12 Were correct bottles used for the analysis requested? ... . ... .. . . YE NO N/A 13 a. Were VOA vials received? ............ ......... . .............................. NO N/A b Was there any observable head space present in any VOA vial?.......... �' YES N/A CYE�14 Was sufficient amount of sample sent in each bottle?. . . . . . .... ... ... . NO NIA 15 Were correct preservatives used?... ... . .... 'E NO NIA If not, record standard ID of preservative used here 16 Was residual chlorine presents . ......... . .• . �� ///. ...NO YES N� l 17 Corrective action taken,if necessary: See attached for resolution Cooler Receipt Form LF-1 9/17/02