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COOLER RECEIPT CHECKLIST Curtis£<TOM;)1 M,ltd. <br /> �!Q Z1� r }} <br /> Login:g Date Received �'��'`� Dumber of coolers 1. <br /> Client Project 1-55, ars- " <br /> Date Opened `,� i 0 By(Print)Y- ('A�f sig� <br /> Date Logged ire' By Cprintj' (si <br /> 1.Did cooler come v6th a shipping slip (airbil-1, etc) YES <br /> Shipping info <br /> 2A. Were custody seals Present? — [a YES (circle) on cooler on samples <br /> How many Name Date <br /> 2B. Were custody seals intact upon arrival? YES, NG—t- <br /> 3.Were custody papers dry and intact when received? Z-11V NO <br /> 4.Were custody papers filled out properly(ink,signed etc)? � NO <br /> S. Is the project identifiable from custody papers?(If so fill out top of form) 1\10 <br /> 6. Indicate th acking in cooler: (if other,describe) <br /> ubble Wrap [I Foam blocks ags [)Non-- <br /> 0 <br /> None0 Cloth material n Cardboard. D Styrofoam [I Paper towels <br /> 7. Temperature documentation: <br /> Type of ice used: Wet ❑Blue/Gel [i None Temp(°C) <br /> ED Samples Received on ice&cold without a temperature blank <br /> �anZples received on ice directly from the field. Cooling process had'begun <br /> S. Were Method 3035 sampling containers present? YES �If YES,what time were they transferred to freezer? <br /> 9.Did all bottles arrive unbroken/unopened?' <br /> 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 /> 15. Are bubbles> 6mm absent in VOA samples? YES NOA <br /> 16. Was the client contacted concerning this sample delivery? YES <br /> If YES,Who was called? By. Date: <br /> COMMM"NTS <br /> SOP volume. Client Services Rev.6 Number 1 of 3 <br /> Section: 1.1.2 Effective:23 July 2008 <br /> Page: I of I Z:\gc\forms\checklists\Cooler Receipt Checklist rv6.doc <br /> 5 of 47 <br />