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TEST AMERICA}INC,-N,ASHVILLE <br /> COOLER RECENT FORM. Cl�tent: r .. <br />' Cooler Received Qn:ff a ,. Artd Qgened Qn: r�r es By: N�Li�l a M� ride <br /> 1. Temperature of Cooler when Opened •° Regrees Celsius <br /> z were cwtod -seaon outside of cooler and infact?......................................YES& <br /> r ls <br /> & If yes what Mud and where: FRONTIBACKISIDE <br /> L 7 wo the dFmtor'3 and date correct?.............................................��►�p��+ <br /> C.. OM��iNoshan� Md .........................I............. YES <br /> • ecooler L............ual...................l aa..aa.ua.•..l u.•.o.�1�LR <br /> 3. Were custody papeza ��....// <br /> 4. Were custody papers properly flood out(mk,eRgaedte#c)?.........................,.... 5 t� <br /> �. d you s4m he M&AY Pape"in he appap�` ft l ?............................�xa <br /> 5. Wbat kind of PACWnF-materia;? <br /> Qum <br /> 7. Was smMe mtimused APrOP"ate)I u.au..+..... is••sala.{..u.a saii.iias a...aa..�s�� <br />' & Did zU L/M..l. e in,good cond uubi ti.ken)?...................... <br /> 9. Were all bo#le labels complete(#,dale,dpe drFre3yek)?...........V.W.,....,.'.,.,..... � <br /> 1a Did in bottle labels and togs agre wia cus"Palms?,,,,,,,,,,,,,,,,.......,...,, NG <br /> 11. Wen correct bottles rimed and present for the am dg requesW?.............••�9"o <br />' M We"WA VWN (....1..{.......a....uu........a\u....µ.......lu....\u.....A.......{uY o <br /> jL l YM Wen sk baMMw ia.........................4..../..aa..a.\N.A a&.4444... <br />' a <br /> 131 Wns mff Beat swat o f seat iu each bottle?................................... <br />' 14. were Correct preservath"Und?....0 u...............................n l...\u.............. T4 <br /> is. yy#f�ua Present?. <br /> .a4 a...1.1.1..1{{........{.{Il.l.�_ <br />' Yl ■`Ydl a <br /> 16 C0nW&6 action taken,ff necessary. <br /> Fume of person contacted: <br /> • Date: <br /> Coaler Fsc�Eaa�e L�=� <br /> 1 <br />