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COOLER RECEIPT CHECKLIST ' <br /> Cb Curtis&Tompkins,Ltd. <br /> Login#_ a M COC, Date Received 3 Number of coolers I ' <br /> Client L)E!bp ' Project <br /> Date Opened 3—Il—C9 BY(Print) F N to,lNp[ (sign ' <br /> Date Logged in. _ 1_p Bypint)r _F \ c (sign) <br /> 1..Did cooler come with a shipping slip (airbill, etc)?:...... ' <br /> Shipping NO <br /> PP� g info_ Fed Ec 9ib�1 Gtb51 Q�(o-7 <br /> 2A. Were custody seals present? .... YES (circle) n Goole on samples ❑ NO <br /> How many a nvP 1 i(L Name_ V(—, Date 3-l l-[)b <br /> 2B. Were custody seals intact upon arrival? ........................................�NO N/A <br /> 3. Were custody papers dry and intact when received?......... ' <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 /> bble Wrap ❑Fb <br /> � oamlockss ❑None <br /> ❑Cloth material ❑Cardboard ❑Styrofoam ❑Paper towels ' <br /> 7. If required, was sufficient ice used? Samples should be<or=6°C ...........C� NO N/A <br /> Type of ice used: h�WET . ❑BLUE ❑NONE Temp(°C) c2 , C5 ' <br /> ❑SAMPLES RECEIVED ON ICE DIRECTLY FROM FIELD.COOLING PROCESS HAD BEGUN. <br /> 8. Were soil Encore sampling devices present? ...............................................YES NO <br /> ............................ <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? ..:............. C3� NO <br /> 12.Do the sample labels agree with custody ? ............. ........... <br /> Papers. ....� NO <br /> .................... <br /> 3. Was sufficient amount of sample sent for tests requested?­.'.*.*.*.­ <br /> equested? ..................... NO ' <br /> 14. Are the samples appropriately preserved? ........... O N/A <br /> . <br /> ............................. <br /> 15. Are bubbles absent in VOA samples?.......... NO N/A <br /> ................................... <br /> 16. Was the client contacted concerning this sample delivery?....... ..YES NO , <br /> If YES, Who was called? By Date: <br /> COMMENTS ' <br /> Qnr ,, COfF. Clffld Q1 two 10,b2 +ire 1602� lD en+ArP�f otS 9�I,nS <br /> 1 <br /> SOP Volume: Client Services ' <br /> Section: 1.1.2 Rev: 4 Number 1 of 3 <br /> Page 1.of I Effective: 06 March 2008 <br /> F:\gc\forms\checklists\Cooler Receipt Checklist_rv4.doc <br /> 1 <br />