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i <br /> I <br /> COOLER RECEIPT CHECKLIST &Tompkins,Ltd. <br /> f <br /> Login# 2 .Z l '�' Date Received /Z Number of olers <br /> Client S t Proj ect t 5 L ��t C C 4;r rpt 4Z. <br /> r -�"7 <br /> Date Opened Z f ,By(print) Al; t��- ':..vr�-(siga) -. 7 " <br /> Date Logged in?By(print} (sign <br /> 1. Did cooler come with a shipping slip(airbill, etc YES .4;D <br /> Shipping info <br /> i 2A.Were custody seals present? ._. ❑YES. (circle) on cooler on samples El <br /> How many Name Date <br /> 2B.Were custody seals intact upon arrival? NO <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 p Foam blocks ;? gs _❑No e <br /> ❑Cloth material ❑Cardboard Q Styrofoarn ❑Par er towels <br /> 7. Temperature documentation: <br /> Type of ice used: E W� ❑Blue/Gel ❑None Temp(°C) <br /> ❑ Samples Received on ice&cold without a temperature blank <br /> ❑ Samples received on ice directly from the field. Cooling process had t egun <br /> 8. Were Method 5035 sampling containers present? YES <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? ZfBS NO <br /> 13.Was sufficient amount of sample sent for tests requested? NO <br /> 14.Are the samples appropriately preserved? . S NO <br /> 15.Are bubbles>6rnm absent in VOA samples? S NO SLA <br /> 16.Was the client contacted concerning this sample delivery? YES NO <br /> If YES,Who was called? By <br /> CONIMENTS <br /> SOP Vohune: Client Services R v.6 Number 1 of 3 <br /> Section: 1.1.2 Eff 've:23 July 2008 <br /> Page: 1 of 1 Z:\qc\forms\checklists\Cooler Recei Checklist rv6.doc <br /> 4of6 <br />