Laserfiche WebLink
ASSOCIATED LABORATORIES <br /> 806 Norah Batavia - Ol ange, California 92868-1225- 714/771-6900 FAX 714/338-1209 <br /> Cooler Receipt Form <br />' Client Project TO C /72-- <br /> V j <br /> Date <br /> 72-- <br /> Date Cooler Received. C /r— Date Cooler Opened <br /> Was cooler scanned for presence of radioactivity 9 Yes <br /> If yes was radioactivity results above 25 cpm ? Ye o <br /> 1 Was a shipper's packmg slip attached to the cooler ? -- -- - - Yes o <br /> If the cooler had custody seal(s),were thy signed and intact 7 (Yes /Na <br /> Was the cooler packed with Ice V Ice Packs Bubble wrap <br /> Styrofoam Paper— None Other <br /> Cooler Temperature 2— 2C-- <br /> *cooler needs to be received @ 4°C with an acceptable range of 2°- 6 'C <br /> If samples were hand delivered do they meot the temp criteria, which should be 4°C with <br /> an acceptable range of 2°- 6 °C 7 cels <br /> o <br /> If no explain <br /> Were all samples sealed in plastic bags Yes/No <br /> Did all samples arrive intact ?If no, indicate belowy s/No <br />' Were all samples labeled correctly ? (ID's Dates, Tunes) If no, indicate below Oe /No <br /> Can the tests required be ran with the provided containers, If no indicate below. es/No <br />' Was sufficient sample volume sent for all containers 9 e <br /> ('Y,YNo <br /> Were any VOA vials received with head space 9 Y..eess/1 To Na <br /> Was the correct preservatives used '? Yes /Na <br /> If no, see the pH log for a list of samples containers regaxding pH <br /> iAny other important information <br /> Receiving De <br /> partinent _.0�„�._.___.._._....-�.._ Date ��.� <br />