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COOLER RECEIPT CHECKLIST , <br /> CE; Curtis&Tompkins, Ltd. <br /> Login # 2a(S'35- Date Received —/�_G ' <br /> Client (��5� ��' Number of coolers <br /> Project�QN�r S7` dtl oc <br /> Date Opened 3-//-o y By(print) , <br /> Date Logged in?-/�B (sign) g <br /> Y(print) /?� <br /> 1. Did cooler come with a shipping slip (airbill, etc)?_.......... 1 <br /> Shipping info 63 si 9ri90 <br /> 9NO <br /> 8'63 6s q 63 / <br /> 2A. Were custody seals present? .... pig (circle) n coo on samples ❑ NO ' <br /> How many 7 Name v <br /> 2B_ Were custody seals iniac— t up Nam _ �s�__•_� Date --c_o y <br /> 3. Were custody papers dry and intact when received?.................................... NO N/A ' <br /> 4. Were custody papers filled out properly(ink, signed, etc)?._......... NO <br /> Ste{ NO <br /> 5- Is the project identifiable from custody papers? (If so fill out top of form).......... S NO . ' <br /> packing in cooler: (if other, describe) <br /> R541tbble Wrap ❑Foam blocks ZBap <br /> El None ' <br /> El Cloth material El Cardboard E3 Styrofoam <br /> 7. If required, was sufficient ice used? Samples should be o 6°C . El Paper towels <br /> or= <br /> ••(g—o NO N/A <br /> Type of ice used: n-wET ❑BLUE ❑NONE <br /> Temp(°C) <br /> ❑SAMPLES RECEIVED ON ICE DIRECTLY FROM FIELD. COOLING PROCESS HAD BEGUN. <br /> 8. Were soil Encore sampling devices present? ........................................... <br /> If YES, what time were they transferred to freezer? """YES NO ' <br /> 9. Did all bottles arrive unbroken/unopened?............... <br /> 10_ Are samples in the appropriate containers for indicated tests?......................••. E NC ' <br /> 11. Are sample labels present, in good condition and complete? ............. NO <br /> 12_ Do the sample labels agree with custody ? ........ NO <br /> 13. Was sufficient amount of sample sent for ests requested? A'W <br /> 14. Are the samples appropriately preserved? •. 9N/A <br /> ' <br /> 15. Are bubbles absent in VOA samples?........................__........._.......... <br /> 16. Was the client contacted conceming this sample deliver ?............. <br /> If YES, Who was called?� 1 l B Y .--• NO ' <br /> Y Date: 3 1/-e- Y <br /> COMMENTS ' <br /> S1eew s <br /> TL y P _ y r GC1,1j,vGcl — Cie: <br /> ✓ l <br /> On -all <br /> SOP Volume: Client Services , <br /> Section: L1.2 Rev: 4 Number.I of 3 <br /> Page I of I Effective:06 March 2008 <br /> F:\qc\forms\checklists\Cooler Receipt Checklist_rv4.doc , <br />