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COOLER RECEIPT CHECKLISTcb Curtis&Tompkins,Ltd. <br /> Login# .z '�' Date Received -i'Z f�l 3 Number of coolers I <br /> Client 1 Project f`i L hr,i k C c_t r r-:1-rW 4Z. <br /> Date Opened TI x I/IT-' By(print) <br /> Date Logged in__V_ By(print) (sign) <br /> 1. Did cooler come with a shipping slip(airbill, etc) YES ./JJD <br /> Shipping info <br /> 2A. Were custody seals present? ... ❑YEAS. (circle) on cooler on samples ❑ <br /> How many Name Date <br /> 213. Were custody seals intact upon arrival? YES NO...-t$-! <br /> 3. Were custody papers dry and intact when received? NO <br /> 4. Were custody papers filled out properly(ink, signed,etc)? � NO <br /> 5. Is the project identifiable from custody papers?(If so fill out top of form) NO <br /> 6. Indicate the packing in cooler: (if other, describe) <br /> ❑Bubble Wrap ❑Foam blocks 2<ags _❑None <br /> ❑Cloth material ❑Cardboard ❑Styrofoam ❑Paper towels <br /> 7. Temperature documentation: <br /> Type of ice used: ❑Blue/Gel ❑None Temp(°C) i4 ' <br /> ❑ Samples Received on iQc & cold without a temperature blank <br /> ❑ Samples received on ice directly from the field. Cooling process had begun <br /> 8. Were Method 5035 sampling containers present? YES 190 . <br /> If YES,what time were they transferred to freezer? <br /> 9.Did all bottles arrive unbroken/unopened? NO <br /> 10. Are samples in the appropriate containers for indicated tests? NO <br /> 11.Are sample labels present,in good condition and complete? NO <br /> 12. Do the sample labels agree with custody papers? NO <br /> 13. Was sufficient amount of sample sent for tests requested? NO <br /> 14. Are the samples appropriately preserved? . YES NO <br /> 6 <br /> 15.Are bubbles> mm absent in VOA samples? YES NO WA <br /> 16. Was the client contacted concerning this sample delivery? YES NO <br /> If YES,Who was called? By Date: <br /> CONVIMENTS <br /> SOP Volume: Client Services Rev.6 Number 1 of 3 <br /> Section: 1.1.2 Effective:23 July 2008 i <br /> Page: 1 of 1 Z:1gclformslcheckhstslCooler Receipt Checklist rv&doc <br /> 4 of 6 <br />